Evidence map›Paper›PMID 27171380›Full record

ArticlePloS one2016

The Sensitivity and Specificity of Loop-Mediated Isothermal Amplification (LAMP) Assay for Tuberculosis Diagnosis in Adults with Chronic Cough in Malawi.

Marriott Nliwasa, Peter MacPherson, Palesa Chisala, Mercy Kamdolozi, McEwen Khundi, Kruger Kaswaswa, Mphatso Mwapasa, Chisomo Msefula, Hojoon Sohn, Clare Flach and 1 more

Open access · goldAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in PloS one, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 32 papers, 8 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
32citing papers in PubMed, 8 pooled it
2.6field-weighted citation impact, top 11% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

32 citing papers in PubMed, 8 syntheses or guidelines pooled it, 51 citations in OpenAlex.

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  18. TB testing in HIV-positive patients prior to antiretroviral treatment.The international journal of tuberculosis and lung disease : the official journal of the International Union against Tuberculosis and Lung Disease · 2022
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

11 authors at 4 institutions in 3 countries.

Marriott NliwasaHelse Nord Tuberculosis Initiative, Department of Microbiology, College of Medicine, Blantyre, Malawi.
Peter MacPhersonDepartment of Public Health and Policy, University of Liverpool, Liverpool, United Kingdom.
Palesa ChisalaDepartment of Surgery, College of Medicine, Blantyre, Malawi.
Mercy KamdoloziHelse Nord Tuberculosis Initiative, Department of Microbiology, College of Medicine, Blantyre, Malawi.
McEwen KhundiMalawi-Liverpool-Welcome Trust Clinical Research Programme, Blantyre, Malawi.
Kruger KaswaswaHelse Nord Tuberculosis Initiative, Department of Microbiology, College of Medicine, Blantyre, Malawi.
Mphatso MwapasaHelse Nord Tuberculosis Initiative, Department of Microbiology, College of Medicine, Blantyre, Malawi.
Chisomo MsefulaHelse Nord Tuberculosis Initiative, Department of Microbiology, College of Medicine, Blantyre, Malawi.
Hojoon SohnDepartment of Epidemiology, Biostatistics & Occupational Health, McGill University, Montreal, Canada.
Clare FlachDepartment of Infectious Disease Epidemiology, London School of Hygiene & Tropical Medicine (LSHTM), London, United Kingdom.
Elizabeth L CorbettHelse Nord Tuberculosis Initiative, Department of Microbiology, College of Medicine, Blantyre, Malawi.
University of Liverpool · GBMalawi-Liverpool-Wellcome Trust Clinical Research Programme · MWLondon School of Hygiene & Tropical Medicine · GBMcGill University · CA

Funding

Medical Research Council MR/K012126/1Wellcome TrustWellcome Trust 091769/Z/10/ZWellcome Trust WT089673
6 · The paper itself

Abstract

backgroundCurrent tuberculosis diagnostics lack sensitivity, and are expensive. Highly accurate, rapid and cheaper diagnostic tests are required for point of care use in low resource settings with high HIV prevalence.

objectiveTo investigate the sensitivity and specificity, and cost of loop-mediated isothermal amplification (LAMP) assay for tuberculosis diagnosis in adults with chronic cough compared to Xpert® MTB/RIF, fluorescence smear microscopy.

methodsBetween October 2013 and March 2014, consecutive adults at a primary care clinic were screened for cough, offered HIV testing and assessed for tuberculosis using LAMP, Xpert® MTB/RIF and fluorescence smear microscopy. Sensitivity and specificity (with culture as reference standard), and costs were estimated.

resultsOf 273 adults recruited, 44.3% (121/273) were HIV-positive and 19.4% (53/273) had bacteriogically confirmed tuberculosis. The sensitivity of LAMP compared to culture was 65.0% (95% CI: 48.3% to 79.4%) with 100% (95% CI: 98.0% to 100%) specificity. The sensitivity of Xpert® MTB/RIF (77.5%, 95% CI: 61.5% to 89.2%) was similar to that of LAMP, p = 0.132. The sensitivity of concentrated fluorescence smear microscopy with routine double reading (87.5%, 95% CI: 73.2% to 95.8%) was higher than that of LAMP, p = 0.020. All three tests had high specificity. The lowest cost per test of LAMP was at batch size of 14 samples (US$ 9.98); this was lower than Xpert® MTB/RIF (US$ 13.38) but higher than fluorescence smear microscopy (US$ 0.65).

conclusionThe sensitivity of LAMP was similar to Xpert® MTB/RIF but lower than fluorescence smear microscopy; all three tests had high specificity. These findings support the Malawi policy that recommends a combination of fluorescence smear microscopy and Xpert® MTB/RIF prioritised for people living with HIV, already found to be smear-negative, or being considered for retreatment of tuberculosis.

Indexed as

AdolescentAdultChronic DiseaseCoughFemaleHIV InfectionsHumansMalawiMaleMiddle AgedNucleic Acid Amplification TechniquesReagent Kits, DiagnosticSensitivity and SpecificityTuberculosisYoung AdultReagent Kits, Diagnostic

Identifiers

PMID27171380
PMCPMC4865214
OpenAlexW2362799088

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.